Please fill out the service request form as completely as possible.
You may also reach us via -
Email: info@professionalcomputersupport.com
Toll Free: (866) 999-6774 Fax: (866) 342-9063
Your Name:
Phone #:
Email Address
Computer System and Related Information:
Is your Company Networked?
Processor:
Motherboard:
RAM:
Hard Drive:
Video Card:
Floppy Drive:
CDROM:
CDRW/DVD:
Data Backup Device:
Case:
OS:
Modem:
Network Card:
Sound Card:
Speakers:
Monitor:
Mouse:
Keyboard:
Antivirus Software:
Software:
Surge Protection:
Service:
Product Brand Computer type N/A PC workstation Windows 2000 Server Windows NT Server Novell Netware Server LInux Server Windows XP Workstation Windows 2000 Workstation Other Computer Model Printer Model N/A HP LaserJet II HP LaserJet IIP HP LaserJet IID HP LaserJet III HP LaserJet IIIP HP LaserJet IIID HP LaserJet IIISi HP LaserJet 4 HP LaserJet 4L HP LaserJet 4P HP LaserJet 4Si HP LaserJet 4M HP LaserJet 4 plus HP LaserJet 4M plus HP LaserJet 5 HP LaserJet 5M HP LaserJet 5L HP LaserJet 5P HP LaserJet 5MP HP LaserJet 5Si HP LaserJet 4000 HP LaserJet 4000T HP LaserJet 4000N HP LaserJet 4000TN HP LaserJet 4050 HP LaserJet 4050T HP LaserJet 4050N HP LaserJet 4050TN HP LaserJet 1100 HP LaserJet 2100 HP LaserJet 2100TN HP LaserJet 8000 HP LaserJet 8100 HP LaserFax 3100 HP LaserJet 6L HP LaserJet 6P HP LaserJet 6MP DotMatrix InkJet Multifunction Laser Multifuntion Ink or Bubble Jet Other - Not Listed Problem
Choose one of the following payment options:
Check Cash Visa Mastercard Prepaid Support AmericanExpress Payment Options Discover Prepaid Support ID: Payment Contact Phone:
Check Cash Visa Mastercard Prepaid Support AmericanExpress Payment Options Discover
Prepaid Support ID:
Phone:
Signature
The services rendered in this agreement contains work product that is of a consultation nature. Due to the inherent nature of this work, costs can and often do exceed the ‘cost value’ of the equipment worked on. Due to the nature of the work product(s) and services required, it is impossible for the equipment serviced to function correctly without such work being performed. Further, at times it may be necessary to perform a given software fix more than one time to effect a final repair, and is in no way the fault of the technician but due to the nature of the way hardware and software functions and malfunctions as a synergetic unit.
Consultation generally consists of: Software installation, diagnosis, troubleshooting, and problem resolution as well as bug fixes, applying service packs, updates and the like; training/tutoring, diagnosis of certain hardware and software related ‘co-habitation’ issues such as operating systems not functioning with certain computer hardware; et al. Performing only diagnostic and/or consultation does not deny Network Services and Solution's right to payment for said diagnostic or consultation services.
After filling out this form, please PRINT this form, sign it and FAX it to: (866) 342-9063 Pressing SUBMIT will forward the information you have entered to our offices via Email.
